Development of subarahnoid perfusion method on thoracoabdominal aneurysm repair

脊髓缺血并导致截瘫是胸主动脉和胸腹主动脉修补术后的严重并发症，即使在今天。本研究旨在观察KW3345和核苷酸转运抑制剂双嘧达莫对兔主动脉修复期脊髓缺血模型神经功能恢复和脊髓诱发电位的影响。方法新西兰大白兔体重2.5~3.0 kg，用氟烷吸入面罩麻醉。在干净的剖腹手术下，阻断肾下腹主动脉、髂动脉分叉部和尾状-肠系膜动脉--脊髓的有力侧支循环，造成脊髓缺血，并形成血管团30分钟。椎板部分切除后在C3和L3水平的硬脑膜后部放置电极，连续记录脊髓诱发电位。各实验组如下：第1组：仅给予生理盐水。第2组：脊髓缺血时肾下动脉节段注射KW3345。第三组：脊髓缺血时肾下动脉段注射潘生丁。结论经肾下腹主动脉节段给予核苷酸转运抑制剂不能作为脊髓缺血的保护作用。

Bacground Spinal cord ischemia with resultant paraplegia is a serious complication after thoracic and thoracoabdominal aortic repair, even nowadays. This study was designed to investigate the effects of KW3345 and dipyridamole, a nucleotide transport inhibitor, on neurological recovery and spinal evoked potentials in a well established rabbit model of spinal cord ischemia during aortic repair.Method New Zealand white rabbits weighting 2.5-3.0 kg were anesthetized with halothane by an inhalation mask. Spinal cord ischemia was produced by occluding the infra-renal abdominal aorta, iliac bifurcation and caudal-mesenteric artery, a potent collateral cerculation to spinal cord, with a vascular clump for a period of 30 minutes under clean laparotomy. Spinal evoked potentials were continuously recorded with an electrode placed on the posterior portion of the dura at C3 and L3 level after partial laminectomy. The experimental groups were as follows, group 1 : only normal saline was administered. Group2 : KW3345 was administered to infra renal aortic segment during spinal ischemia. Group3 : Dipyridamole was administered to infra-renal aortic segment during spinal ischemia.Result All animals showed complete paralysis of the hind limbs. Spinal evoked potentials were not monitoered during ischemia in all animals.Conclusion Administration of nucleotide transport inhibitor through infra-renal aortic segment cannt be used as protection of ischemia of the spinal cord.